Stroke cures Quebec man of cocaine addiction, researchers report

Sharon Kirkey, Postmedia News10.22.2012

The patient experienced some temporary paralysis on his right side, but recovered rapidly. There were no lingering "deficits" or side effects, Lanthier reports, save for one: the man developed "micrographia," abnormally small handwriting.

Montreal researchers are reporting on the curious case of a Quebec man apparently cured of a cocaine addiction following a stroke.

Although it's based on a single case report, the finding could set the foundation for more research into whether it's possible to target and treat the underlying brain regions behind drug abuse, possibly with deep brain stimulation.

The case involves a 45-yearold man who had been addicted to cocaine since he was 24, injecting or snorting up to seven grams a day.

Twenty-one months ago, he experienced a stroke affecting the basal ganglia, a large clusters of nerve cells located deep in the brain that receive dopamine - the neurotransmitter involved in the brain's pleasure and reward system that's important for addictive behaviours.

When people do something pleasurable, the brain releases a surge of dopamine that reinforces that behaviour, said lead researcher Dr. Sylvain Lan-thier, an associate professor at the University of Montreal and director of the neurovascular program at Centre hospitalier de l'Universite de Montreal.

Cocaine enhances the effects of dopamine, but it's short-acting. "You have a big rush of dopamine, and then suddenly it goes away," Lanthier said. "That's why you feel the need to use again."

In an abstract presented at the recent Canadian Stroke Congress in Calgary, Lanthier's team reported that, "remarkably, (the man) reported no further craving for cocaine following stroke onset."

He scored nine out of 10 on a drug abuse screening test pre-stroke, "indicating a severe level of problems related to drug use," the researchers wrote, and a zero out of 10, post-stroke.

"The man doesn't experience any craving, any sensation that he needs to take cocaine," Lan-thier said.

The patient experienced some temporary paralysis on his right side, but recovered rapidly. There were no lingering "deficits" or side effects, Lanthier reports, save for one: the man developed "micrographia," abnormally small handwriting.

It's believed to be the first reported case of cocaine addiction relieved by a stroke.

Current addiction treatments primarily involve a combination of cognitive behavioural therapy, or talk therapy, and anti-depressants.

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Stroke cures Quebec man of cocaine addiction, researchers report

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